CN1463187A - Method and device for plasma surgery - Google Patents

Method and device for plasma surgery Download PDF

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Publication number
CN1463187A
CN1463187A CN 02802167 CN02802167A CN1463187A CN 1463187 A CN1463187 A CN 1463187A CN 02802167 CN02802167 CN 02802167 CN 02802167 A CN02802167 A CN 02802167A CN 1463187 A CN1463187 A CN 1463187A
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apc
turned
high
frequency voltage
coagulation
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CN 02802167
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Chinese (zh)
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CN100393288C (en
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G·法林
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埃尔贝电疗有限公司
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/042Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating using additional gas becoming plasma

Abstract

一种用于氩等离子凝固(APC)的器械,其中,在启动APC器械后,在用于离子化惰性气体的高频电压被接通或能被接通之前,一确定量的惰性气体流出APC器械。 Before instrument for argon plasma coagulation (APC), wherein, after starting the APC instrument, it can be switched on or switched high-frequency voltage to ionize the inert gas, a certain quantity of inert gas flowing APC instrument. 结果,安全性得到提高。 As a result, safety is improved.

Description

用于等离子手术的方法和器械 A method for the plasma surgical instrument and

技术领域 FIELD

本发明涉及一种用于等离子手术的方法和器械。 The present invention relates to a method and apparatus for plasma operation.

背景技术 Background technique

等离子手术是高频外科手术的一种方法,其中,高频交流电(HF电流)通过电离的并因此而导电的惰性气体(等离子),尤其是氩气(氩等离子)或氦气(氦等离子),施加到待治疗组织上并在该目标组织上产生与外科手术相关的热效应。 Plasma surgery is a method for high-frequency surgery, wherein the high frequency alternating current (HF current) by ionizing and thus conducting an inert gas (plasma), in particular argon (Ar plasma) or helium (helium plasma) , to be applied to the treatment of tissue and thermal effects associated with surgery on the target tissue. 最经常用于该目的的惰性气体是氩气,在该组织上最已知的热效应是凝固/凝结(Koagulation),因此,该方法也被称作“氩等离子凝固(APC)”。 Inert gas is most often used for this purpose is argon, in the organization of the thermal effect is most known coagulation / condensation (Koagulation), and therefore, this method is also called "argon plasma coagulation (the APC)." 原则上其它气体或混合气体可以代替惰性气体用于等离子手术。 In principle, other gases or a mixed gas of an inert gas may be replaced for the plasma operation. 例如,空气曾用作该种气体50多年,在这种情况下该方法称为电灼疗法或喷射凝固法(Spray-Koagulation)。 For example, air was used as such gas 50 years, in which case the method is called fulguration or coagulation jet (Spray-Koagulation). 然而,惰性气体的优点是它们不会引起任何化学作用,即,它们具有化学中性行为。 Advantage of the inert gas, however, is that they do not cause any chemical action, i.e., they have sexual chemistry. 该优点可特别地用于等离子手术的内窥镜应用,这时如果使用空气,则会因不可避免的烟雾的形成而妨碍观察,而与空气的使用不可避免地相关联的生物组织的灼伤或汽化会导致严重的并发症,例如器官壁的穿孔。 This advantage may be particularly useful for endoscopic applications like plasma surgery, then if air is used, will be inevitable due to the formation of smog impede observation inevitably associated biological tissue burns associated with using air or vaporization can lead to serious complications, such as perforation of the organ wall.

对开口切开法和微创手术两者而言,等离子手术已经使用了20多年,主要用于通过发热即通过生物组织的热凝固,进行止血。 For both of the opening incision, and minimally invasive surgical method, plasma surgery has been used for over 20 years, mainly used i.e. by thermal coagulation of biological tissue by heat, hemostasis. 在该方法中或者使用早已存在的空气作为所需气体,如在电灼疗法或喷射凝固法的情况下,或者使用一种惰性气体,在这种情况下该方法称为氩等离子凝固(APC),这是因为这种最经常使用的气体是氩气。 In the method or using the already existing air as the desired gas, as in the case fulguration coagulation or spray, or using an inert gas, in which case the method is called an argon plasma coagulation (APC) this is most often used because such gas is argon.

自从类似导尿管的、柔性的器械被开发用于APC以来,其中该器械可以通过一个柔性内窥镜的工作或器械通道插入(G.Farin等:与内窥镜应用密切相关的氩等离子凝固技术;内窥外科与联合技术,No.1,卷2,1994年2月,71-77页),APC也可以用于柔性内窥镜检查法。 Since a similar catheter, flexible instrument since been developed for the APC, wherein the instrument can be inserted through a flexible endoscope or working channel instrument (G.Farin like: endoscopic applications is closely related to an argon plasma coagulation technology; endoscopic surgical techniques and combined, Nos. 1, Vol. 2, February 1994, pages 71-77), APC may also be used in a flexible endoscopy. 很快就表明在该领域APC方法有很宽的适应症范围。 Soon indicates a wide range of indications in the field of the APC methods. 除热止血法外,APC用于柔性内窥镜检查中以完成例如病理学组织的热失活或破坏等任务(Grund KE,Storek D.,Farin G.:内窥镜氩等离子凝固法(APC)—柔性内窥镜检查法的第一手临床经验,内窥外科与联合技术,No.1,卷2,1994年2月,42-46页)。 In addition to thermal hemostasis, APC for flexible endoscopy is completed, for example, to heat inactivation or pathological tissue destruction task (Grund KE, Storek D., Farin G .: endoscopic argon plasma coagulation (APC ) - first-hand clinical experience of flexible endoscopy, endoscopic surgery and United technologies, No.1, Vol. 2, February 1994, pp. 42-46). 尽管考虑到该方法在柔性内窥镜检查中的最新的适应症,术语氩-等离子凝固法(APC)现在已过于狭隘,而“氩-等离子手术”更为合适,但此处将继续使用“氩-等离子凝固法(APC)”指代该方法,并不将该方法局限于惰性气体氩气或局限于作为热效应的凝固法。 While taking into account the latest indication of the method in a flexible endoscopy, the term Ar - plasma coagulation (APC) is now too narrow, and "Ar - Plasma operation" is more suitable, but will continue to use here " Ar - plasma coagulation (APC) "refers to the method, the method is not limited to an inert gas such as argon, or be limited to the heat coagulation effect.

在德国专利DE 4139029中对自从1992年就可应用于柔性内窥镜检查法的APC装置作了说明。 In German Patent DE 4139029 since APC pair of device 1992 can be applied to a flexible endoscopy has been described.

在胃肠道中和在气管支气管系统和咽喉区域中使用热方法的一个公知的问题是,存在无意识地点燃易燃或甚至易爆炸物质的风险。 In the gastrointestinal tract and a well-known problem in the use of thermal methods tracheobronchial system and throat region, the presence of unintentionally ignite flammable or even explosive material risk. 在胃肠道中可能包含可由等离子的相对高温点燃的易燃内生气体。 It may be contained in the plasma of the gastrointestinal tract in a relatively high temperature to ignite inflammable raw gases. 在气管支气管系统中,呼吸的气体可能具有高氧浓度,或者病人甚至在吸入纯氧,因此由热等离子所点燃的易燃物质会导致烈火。 In the tracheobronchial system, the respiratory gas may have a high oxygen concentration, or even the patient inhalation of pure oxygen, thus the thermal plasma ignited flammable substances can cause fire. 已知有多起因此而造成的具有致命或非致命后果的损伤病例。 How it has known since injury was fatal or nonfatal consequences resulting therefrom. 尽管惰性气体不会引起火,但即使在使用APC时也还知道由火和/或爆炸而造成的损伤。 Although the inert gas does not cause the fire, but even when using the APC also know damage caused by fire and / or explosion caused.

发明内容 SUMMARY

本发明的目的是通过这样一种方式,即避免点燃易燃物质,来改善APC装置。 Object of the present invention is such a way, i.e. to avoid ignition of combustible material, to improve the APC device.

该目的通过该方法实现,即,在例如通过一个踏板或一个指控开关启动APC装置以后,一股确定量的氩气流出各APC器械或使用中的APC探针Pr的远端,这降低易燃气体例如一氧化碳(CO),和/或导致易燃气体燃烧的气体例如氧气的浓度,到达不可能点燃该混合气体的程度。 This object is achieved by this method, i.e., after, for example, through a pedal or switch to start a allegation APC means, determining an amount of a distal end of a stream of argon APC APC probe Pr each instrument or in use, which reduces the flammability For example, the degree and / or combustion of flammable gas concentration of gas such as oxygen, can not reach the ignition of the mixed gas of carbon monoxide (CO) gas. 在下文中,该氩气的量称为预氩气流。 Hereinafter, the amount of the argon gas is called a pre-argon stream.

为了最小化在由预氩气流造成的APC起动以前的时间延迟Δt,使该(预)氩气流速尽可能地高是有用的;通常它可以高于(高)用于APC(低)的氩气流速。 In order to minimize the APC argon stream resulting from the pre-start delay time before Δt, so that the (pre) argon flow rate as high as possible is useful; in general it can be higher (high) for the APC (low) Ar gas flow rate. 在这里预氩气流量取决于相关边界条件将是有利的;这可以通过在使用APC之前手动调节,或者通过边界条件的自动监测控制而自动控制或者调节而完成。 Here the pre-argon gas flow depends on the relevant boundary conditions it would be advantageous; this can be manually adjusted prior to use by APC, or automatically control or regulation is accomplished by monitoring and controlling the automatic boundary conditions. 例如,可以与所呼吸气体中的氧气浓度成比例地确定预氩气流,或者可以自动控制或调节。 For example, the pre-determined proportion to the concentration of argon gas stream with the oxygen we breathe, or may be automatically controlled or regulated. 此外,预氩气流还可以,通过预先调节或通过一个控制或调节装置,与该方法的两个或多个启动之间的暂停时间成比例,和/或与APC自身的启动时间成比例。 Further, the pre argon stream can, by adjusting in advance or by a control or regulating device, and the pause time between two or more of the method is proportional to start, and / or APC itself proportional to the time of startup.

一种适于实现上述目的的装置由一个氩气源Ar例如一个气瓶组成,该气瓶安装有至少一个可控气阀V和至少有一个气流传感器Se,它们可用于手动设置预氩气流和APC所需的氩气流速。 An apparatus adapted to implement the above-mentioned object is a source of argon gas from the Ar gas cylinder, for example, a composition, which cylinder is attached to at least one controllable valve V air flow sensor and at least one of Se, they may be used to manually set the pre-argon stream and APC desired argon flow rate. 对于预氩气流和/或APC所需的氩气流速的自动控制和/或调节,硬件优选地附加安装控制和/或调节元件Ct。 Argon flow required for the pre-and / or APC argon flow rate of automatic control and / or regulation, preferably additional mounting hardware control and / or regulating elements Ct. 在本发明的另一个实施例中,该硬件还包括存储器和处理器,允许编程和对预氩气流和/或APC所需的氩气流速进行自动控制和/或调节。 In another embodiment of the present invention, the hardware also includes memory and a processor, programming, and allows the argon flow rate to argon flow and pre / or APC required to automatically control and / or regulation.

在此参照附图。 Herein with reference to the accompanying drawings.

Claims (7)

1.一种用于氩等离子凝固(APC)的器械,其特征在于,在启动APC器械后,在用于离子化惰性气体的高频电压被接通或能被接通之前,一确定量的惰性气体流出APC。 1. An apparatus for argon plasma coagulation (APC) of the device, wherein, after starting the APC instrument, it can be switched on or switched high-frequency voltage for ionizing the inert gas prior to determining the amount of a inert gas flows APC.
2.根据权利要求1所述的氩等离子凝固(APC)器械,其特征在于,可以预先调节在高频电压被接通或能被接通之前流出APC器械的惰性气体的量。 2. Ar plasma according to claim 1 coagulation (APC) device, characterized in that the amount of inert gas flowing out of the APC instrument before it is turned on or turned on at the high frequency voltage may be adjusted in advance.
3.根据权利要求1或2的氩等离子凝固(APC)器械,其特征在于,在高频电压被接通或能被接通之前流出APC器械的惰性气体的量取决于变化的边界条件。 1 or 3. Ar plasma according to claim 2 coagulation (APC) device, characterized in that the can is turned ON or boundary conditions of the amount of inert gas flowing APC instrument before the high-frequency voltage variations depends.
4.根据权利要求3所述的氩等离子凝固(APC)器械,其特征在于,在启动的两个阶段之间的暂停越长,和/或之前启动的期间越短,则在高频电压被接通或能被接通之前流出APC器械的惰性气体的量就越大。 Ar plasma according to claim 3, wherein said coagulation (APC) device, characterized in that, the longer the pauses between the start of two phases, and / or the shorter the period before the start of the high-frequency voltage is amount of inert gas flowing out of the APC instrument before the greater can be turned on or turned.
5.根据权利要求1所述的氩等离子凝固(APC)器械,其特征在于,在从氩等离子凝固(APC)器械的启动到高频电压被接通的时间间隔中,产生一种听觉和/或视觉信号,通知使用者高频电压尚未接通或不能接通。 The argon ions and the like according to claim 1 coagulation (APC) device, wherein the time interval coagulation (APC) from the argon plasma instrument to start the high-frequency voltage is turned on, and produce an audible / or visual signal, informing the user of a high-frequency voltage has not turned on or not.
6.根据权利要求1所述的氩等离子凝固(APC)器械,其特征在于,只要确定量的氩气尚未流出APC器械,则高频电压不接通或不能被接通。 6. The argon plasma coagulation according to claim 1 (APC) device, characterized in that, as long as not yet determined the amount of argon gas outflow APC instrument, the high frequency voltage is not or can not be turned ON.
7.根据权利要求1所述的器械,其特征在于,该器械以这样一种方式控制,在器械启动之后但在高频电压接通之前时,惰性气体流出的速率即每单位时间的体积比在一个APC程序中高频电压接通之后的速率大。 7. The apparatus according to claim 1, characterized in that the control device in such a manner, but before the high-frequency voltage is turned on after starting the instrument, i.e., the rate of the inert gas flowing out of the volume per unit of time APC at a rate after the high-frequency voltage is switched on a large program.
CN 02802167 2001-06-22 2002-06-20 Device for plasma surgery CN100393288C (en)

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DE2001129685 DE10129685B4 (en) 2001-06-22 2001-06-22 Method and device for argon plasma coagulation
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CN102711638A (en) * 2009-09-11 2012-10-03 厄比电子医学有限责任公司 Multi-functional element and method for hindering the carbonisation of tissue by means of a multi-functional element
CN107518942A (en) * 2017-07-03 2017-12-29 重庆金山医疗器械有限公司 A kind of argon flow amount control method and control system

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CN102458290B (en) * 2009-04-16 2014-10-22 厄比电子医学有限责任公司 Endoscopic surgical instrument
CN102711638A (en) * 2009-09-11 2012-10-03 厄比电子医学有限责任公司 Multi-functional element and method for hindering the carbonisation of tissue by means of a multi-functional element
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CN107518942A (en) * 2017-07-03 2017-12-29 重庆金山医疗器械有限公司 A kind of argon flow amount control method and control system

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DE50208075D1 (en) 2006-10-19
WO2003000150A1 (en) 2003-01-03
JP4143537B2 (en) 2008-09-03
US7601150B2 (en) 2009-10-13
EP1397083A1 (en) 2004-03-17
JP2004530495A (en) 2004-10-07
CN100393288C (en) 2008-06-11
US20040181220A1 (en) 2004-09-16

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